Remove Cardiogenic Shock Remove Chest Pain Remove Pericarditis
article thumbnail

Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

This is a value typical for a large subacute MI, n ormal value 48 hours after myocardial infarction is associated with Post-Infarction Regional Pericarditis ( PIRP ). As already mentioned, this patient could have post-infarction regional pericarditis from a large completed MI. The VSR is what is causing the cardiogenic shock!

article thumbnail

Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They described the chest pain as severe, crushing, and non-radiating. Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close).

article thumbnail

Chest Pain and Inferior ST Elevation.

Dr. Smith's ECG Blog

A middle-aged patient with lung cancer had presented to clinic complaining of generalized malaise, cough, and chest pain. Symptoms other than chest pain (malaise, cough in a cancer patient) 2. I have always said that tachycardia should argue against acute MI unless there is cardiogenic shock or 2 simultaneous pathologies.

article thumbnail

Should we activate the cath lab? A Quiz on 5 Cases.

Dr. Smith's ECG Blog

All of the patients presented with chest pain , and they are all in triage. The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician.

Ischemia 109
article thumbnail

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Dr. Smith's ECG Blog

A man in his 60's presented after 4 days of chest pain, with some increase of pain on the day of presentation. Exact pain history was difficult to ascertain. When there is MI extending all the way to the epicardium (transmural), that infarcted epicardium is often inflamed (postinfarction regional pericarditis, or PIRP).

STEMI 52